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PMMC Healthcare Revenue Cycle Blog
Stay up to date on best practices for healthcare revenue cycle management with PMMC's blog.
Strategic Pricing Drove Up To a 15 Percent Increase in Net Revenue
Effective pricing strategies are critical for driving profitability in healthcare organizations. Organizations that take a strategic approach to chargemaster adjustments often see significantly better results—reporting between a 2 to 15 percent increase in average net revenue year-over-year (YoY), compared to just 3 percent for those without such strategies. Here’s how these targeted adjustments lead to substantial growth and why they matter.
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Timely Filing Denials are on the Rise. Here's What You Need to Know
Timely filing denial rates are hitting revenue cycle teams harder than ever, with a staggering 267% increase YoY for timely filing denials on appeals. This surge is more than just an unsettling trend; it represents significant revenue loss and operational inefficiency. To protect your organization’s bottom line, addressing this issue requires both immediate action and strategic contract renegotiations.
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Business Insights | Contract Modeling
Leveraging Medicare Benchmarks in Contract Negotiations
When it comes to hospital reimbursement, one statistic often dominates the conversation—on average, hospital commercial reimbursement is coming in at approximately two to three times Medicare reimbursement. It’s critical to understand how your organization stacks up against industry benchmarks since this can significantly affect preparations for contract negotiations and your bottom line. Through analysis, we've found reimbursements to be approximately 200%-215% of Medicare. But here's the big question—how do you use this data strategically to enhance contract negotiations, improve financial planning and analysis (FP&A), and maximize net revenue?
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Why a Safety-Net Review could save you millions
Denials and underpayments are a constant challenge for hospitals, putting significant pressure on financial teams to recover lost revenue. With continual market shifts and inconsistencies in payor behavior, staying on top of these issues can feel like a moving target. That’s where having a safety-net review comes in—leveraging analytics, AI technologies, and decades of expertise to help hospital teams recover cash, minimize false variances, and optimize reimbursement processes.
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Keeping Accounts Receivable Under Control and Ensuring Financial Health
With a 21% increase in Accounts Receivable (AR) trends, is your team preparing for impacts on your organization's financial health? We're taking a closer look at aging Accounts Receivable (AR) – a vital indicator often influenced by external factors, like changes in payer behaviors and increasing denials.
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Protecting Yourself & Your Team from Phishing Attacks
In today's digital age, avoiding online scams has become more crucial than ever. With the growing prevalence of digital platforms for communication, shopping, and banking, cybercriminals continually develop new techniques to exploit unsuspecting users. Falling victim to online scams can lead to financial losses, identity theft, and compromised personal information—consequences that can be both costly and life-disrupting. By staying informed and adopting proactive measures, individuals and organizations can safeguard themselves against these threats and foster a safer online environment.
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Insurance Payments Continue to be Delayed Year over Year—What It Means for You
The healthcare revenue cycle is facing new challenges that can’t be ignored. Analysis of industry data reveals a concerning trend—payors took approximately 42% longer to pay in Q3 2024 compared to Q3 2023. This means cash flow disruptions, extended recovery times, and potentially significant financial impacts on your organization. Payment delays not only strains healthcare organizations but also fuels public frustration, as individuals grow increasingly discontent with the financial tactics affecting their access to timely and quality care.
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As We Approach 2025, Healthcare Organizations Need to be Prepared
As we bid farewell to 2024 and step into the new year, it's the perfect time to reflect on the past year and prepare for what lies ahead in 2025. In this article, we examine five significant takeaways from 2024, weighing their impact on the healthcare industry and offering valuable lessons for the future. Explore the key trends, challenges, and opportunities shaping 2025, and gain valuable information to navigate the coming year.
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Navigating the Rising Tide of Prior Authorization Denials
Prior authorization denials are a major headache for many healthcare organizations. As hospitals and healthcare organizations grapple with this persistent issue, it's crucial to grasp its implications and devise smart strategies to curb revenue losses. By tapping into analytics and insights, organizations can boost their operations and enhance overall performance. This article delves into the challenges posed by these denials, the ongoing rise in numbers, and practical ways to tackle them head-on.
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